Heights University Hospital

All Charges

Charge

Type

Setting

Price

MASK OXYGEN MED CONCENTRATION

Facility

$13.65

Hospital Charge Code	270611535
Hospital Revenue Code	272
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$4.09
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.77
Rate for Payer: Oxford Commercial	$6.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$6.83

MASK OXYGEN MED CONCENTRATION

Facility

$2.32

Hospital Charge Code	270616791
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$1.16
Rate for Payer: Aetna Commercial	$0.70
Rate for Payer: Aetna Medicare Advantage	$0.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.59
Rate for Payer: Cigna Commercial	$1.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$0.35
Rate for Payer: UnitedHealthcare Commercial	$1.16

MASK OXYGEN MED CONCENTRATION

Facility

$2.32

Hospital Charge Code	270616791
Hospital Revenue Code	272
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.35
Rate for Payer: Qualcare PPO/HMO/WC	$0.35

MASK OXYGEN MED CONCENTRATION

Facility

$13.65

Hospital Charge Code	270611535
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

MASK OXYGEN NON-REBREATHER

Facility

$11.55

Hospital Charge Code	270654268
Hospital Revenue Code	270
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$5.78
Rate for Payer: Aetna Commercial	$3.46
Rate for Payer: Aetna Medicare Advantage	$3.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.95
Rate for Payer: Cigna Commercial	$5.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$5.78
Rate for Payer: Qualcare PPO/HMO/WC	$1.73
Rate for Payer: UnitedHealthcare Commercial	$5.78

MASK OXYGEN NON-REBREATHER

Facility

$11.55

Hospital Charge Code	270654268
Hospital Revenue Code	270
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$1.73
Rate for Payer: Qualcare PPO/HMO/WC	$1.73

MASK PEDI AERSL ELEPHNT 001276

Facility

$6.25

Hospital Charge Code	270638579
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$3.12
Rate for Payer: Aetna Commercial	$1.88
Rate for Payer: Aetna Medicare Advantage	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.59
Rate for Payer: Cigna Commercial	$3.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.81
Rate for Payer: Oxford Commercial	$3.12
Rate for Payer: Qualcare PPO/HMO/WC	$0.94
Rate for Payer: UnitedHealthcare Commercial	$3.12

MASK PEDI AERSL ELEPHNT 001276

Facility

$6.25

Hospital Charge Code	270638579
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$0.94
Rate for Payer: Qualcare PPO/HMO/WC	$0.94

MASK PEDIATRIC AEROSOL

Facility

$2.41

Hospital Charge Code	270613881
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Qualcare PPO/HMO/WC	$0.36

MASK PEDIATRIC AEROSOL

Facility

$2.41

Hospital Charge Code	270613881
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$1.21
Rate for Payer: Aetna Commercial	$0.72
Rate for Payer: Aetna Medicare Advantage	$0.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.61
Rate for Payer: Cigna Commercial	$1.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.31
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.36
Rate for Payer: UnitedHealthcare Commercial	$1.21

MASK PEDIATRIC DRAGON

Facility

$170.90

Hospital Charge Code	270630009
Hospital Revenue Code	270
Min. Negotiated Rate	$25.64
Max. Negotiated Rate	$25.64
Rate for Payer: Qualcare PPO/HMO/WC	$25.64

MASK PEDIATRIC DRAGON

Facility

$170.90

Hospital Charge Code	270630009
Hospital Revenue Code	270
Min. Negotiated Rate	$22.22
Max. Negotiated Rate	$85.45
Rate for Payer: Aetna Commercial	$51.27
Rate for Payer: Aetna Medicare Advantage	$51.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.58
Rate for Payer: Cigna Commercial	$85.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.22
Rate for Payer: Oxford Commercial	$85.45
Rate for Payer: Qualcare PPO/HMO/WC	$25.64
Rate for Payer: UnitedHealthcare Commercial	$85.45

MASK PEDIATRIC NON-REBREATHER

Facility

$8.15

Hospital Charge Code	270622711
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$4.08
Rate for Payer: Aetna Commercial	$2.44
Rate for Payer: Aetna Medicare Advantage	$2.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.08
Rate for Payer: Cigna Commercial	$4.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.06
Rate for Payer: Oxford Commercial	$4.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.22
Rate for Payer: UnitedHealthcare Commercial	$4.08

MASK PEDIATRIC NON-REBREATHER

Facility

$8.15

Hospital Charge Code	270622711
Hospital Revenue Code	272
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.22

MASK PED MAN RES CHILD

Facility

$48.03

Hospital Charge Code	270669811
Hospital Revenue Code	270
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

MASK PED MAN RES CHILD

Facility

$48.03

Hospital Charge Code	270669811
Hospital Revenue Code	270
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$24.02
Rate for Payer: Aetna Commercial	$14.41
Rate for Payer: Aetna Medicare Advantage	$14.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.25
Rate for Payer: Cigna Commercial	$24.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$24.02
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$24.02

MASK PERCENT O2 ADULT DISP

Facility

$250.30

Hospital Charge Code	270653960
Hospital Revenue Code	270
Min. Negotiated Rate	$32.54
Max. Negotiated Rate	$125.15
Rate for Payer: Aetna Commercial	$75.09
Rate for Payer: Aetna Medicare Advantage	$75.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.83
Rate for Payer: Cigna Commercial	$125.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.54
Rate for Payer: Oxford Commercial	$125.15
Rate for Payer: Qualcare PPO/HMO/WC	$37.55
Rate for Payer: UnitedHealthcare Commercial	$125.15

MASK PERCENT O2 ADULT DISP

Facility

$250.30

Hospital Charge Code	270653960
Hospital Revenue Code	270
Min. Negotiated Rate	$37.55
Max. Negotiated Rate	$37.55
Rate for Payer: Qualcare PPO/HMO/WC	$37.55

MASK PERFORMATRAK LARGE WITH

Facility

$156.29

Hospital Charge Code	270641430
Hospital Revenue Code	272
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$23.44
Rate for Payer: Qualcare PPO/HMO/WC	$23.44

MASK PERFORMATRAK LARGE WITH

Facility

$156.29

Hospital Charge Code	270641430
Hospital Revenue Code	272
Min. Negotiated Rate	$20.32
Max. Negotiated Rate	$78.14
Rate for Payer: Aetna Commercial	$46.89
Rate for Payer: Aetna Medicare Advantage	$46.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.85
Rate for Payer: Cigna Commercial	$78.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.32
Rate for Payer: Oxford Commercial	$78.14
Rate for Payer: Qualcare PPO/HMO/WC	$23.44
Rate for Payer: UnitedHealthcare Commercial	$78.14

MASK PERFORMATRAK MEDIUM WITH

Facility

$111.48

Hospital Charge Code	270641429
Hospital Revenue Code	272
Min. Negotiated Rate	$16.72
Max. Negotiated Rate	$16.72
Rate for Payer: Qualcare PPO/HMO/WC	$16.72

MASK PERFORMATRAK MEDIUM WITH

Facility

$111.48

Hospital Charge Code	270641429
Hospital Revenue Code	272
Min. Negotiated Rate	$14.49
Max. Negotiated Rate	$55.74
Rate for Payer: Aetna Commercial	$33.44
Rate for Payer: Aetna Medicare Advantage	$33.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.43
Rate for Payer: Cigna Commercial	$55.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.49
Rate for Payer: Oxford Commercial	$55.74
Rate for Payer: Qualcare PPO/HMO/WC	$16.72
Rate for Payer: UnitedHealthcare Commercial	$55.74

MASK PERFORMATRAK SMALL WITH

Facility

$156.29

Hospital Charge Code	270641428
Hospital Revenue Code	272
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$23.44
Rate for Payer: Qualcare PPO/HMO/WC	$23.44

MASK PERFORMATRAK SMALL WITH

Facility

$156.29

Hospital Charge Code	270641428
Hospital Revenue Code	272
Min. Negotiated Rate	$20.32
Max. Negotiated Rate	$78.14
Rate for Payer: Aetna Commercial	$46.89
Rate for Payer: Aetna Medicare Advantage	$46.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.85
Rate for Payer: Cigna Commercial	$78.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.32
Rate for Payer: Oxford Commercial	$78.14
Rate for Payer: Qualcare PPO/HMO/WC	$23.44
Rate for Payer: UnitedHealthcare Commercial	$78.14

MASK PERFORMAX FACE LG 105532

Facility

$220.00

Hospital Charge Code	270643112
Hospital Revenue Code	270
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

Know your out-of-pocket cost for care.

All Charges